Adolescents and young adults 24 years of age and under are among the fastest growing U.S. demographic groups acquiring HIV. The prevalence of HIV infection is disproportionately higher among male-to-female (MTF) transgender individuals, with estimates of HIV prevalence ranging from 11% to greater than 50%. Gender discrimination and stigma, personal attributes (e.g. knowledge, attitudes and beliefs about HIV and substance use), life skill deficits and health care disparities have all been hypothesized as factors associated with HIV risk behaviors in MTF transgender youth. HIV intervention programs tailored specifically to this population currently do not exist. The proposed pilot study is consistent with the conceptual goals of RFA PS06-005: Identifying Ground-Breaking Behavioral Interventions to Prevent Human Immunodeficiency Virus (HIV) Transmission in High-Risk Groups. The goal of this study is to use a Social Ecological framework to develop a multi-dimensional HIV prevention program that is tailored to fit the unique needs of this high risk subgroup. The proposed intervention will contain both an individual and group component. The group level intervention will be based off a manual curriculum that focuses on risk behaviors known to be prevalent within this subgroup, including, but not limited to HIV knowledge deficiencies, homelessness, unprotected sex and substance use. The individual level intervention will involve participants meeting one-on-one with the Participant Advocate to address basic needs (access to health care, employment, housing, etc.), further develop skills covered in the group level intervention and to develop individualized behavior goals. Study aims are 1) to develop an HIV prevention intervention for male-to-female transgender young people ages 16- 24; and 2) to evaluate feasibility, tolerability, and acceptability of a multi-dimensional HIV prevention intervention; 3) to test a multi-dimensional intervention with 50 MTF Transgender youth ages 16-24 and examine preliminary effects on risky sexual behavior in preparation for a large-scale, efficacy study. The long-term goal of the proposed pilot project is to develop an empirically validated, scientifically based HIV prevention program to reduce HIV risk behavior among MTF transgender youth ages 16-24. Consistent with the goals of the RFP, the final product will be the basis for a multi-site intervention that will be sufficiently brief and of a technical level that can be rapidly disseminated to community-based organizations. [unreadable] [unreadable] [unreadable] [unreadable]